Individual
REZA FAKHRSHAFAEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
1640 SW 119TH ST, OKLAHOMA CITY, OK 73170-4908
(405) 692-3432
Mailing address
11520 CEDAR VALLEY DR, OKLAHOMA CITY, OK 73170-5667
(405) 651-1609
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11384
OK
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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